Diagnostic mammography studies at Wake Radiology are always directed by a radiologist who is onsite. The technologist is, therefore, able to review all images with the radiologist to ensure that the appropriate number and type of additional views are taken during the appointment. This approach improves the quality of the interpretation – and subsequent outcomes – as well as decreases the number of duplicate exams. Our approach also allows our radiologists to consult personally with patients and review their results before they leave the office.

Comparison Sets for Informed Interpretations

Wake Radiology strives to access and leverage the greatest amount of related clinical information we can when we perform diagnostic mammograms. Screening and diagnostic mammograms are compared to multiple previous years to ensure the fewest possible false positives and false negatives, which decrease the rate of unnecessary recalls and improve detection. While some radiology providers stop at two years of comparison, Wake Radiology goes as far back as possible for an average of 5-7 years, which is very important in evaluating a patient’s current exam for a change that could signal subtle cancer. Dedicated staff members handle this labor-intensive prior exam retrieval process so that the prior imaging and information is readily available to our breast imaging radiologists when needed.

Hands-on Approach

Wake Radiology understands how anxious patients are when they are waiting for results — especially those who are considered at high risk of developing breast cancer. When patients return for their diagnostic mammogram evaluation, they meet with our physicians who take the time to review results and images with them so they know the thought process behind their diagnosis. We also discuss possible next clinical management steps so they are more informed about how their referring physician may manage their breast diagnosis. Our hands-on approach diminishes patient anxiety associated with continued uncertainty.

Wake Radiology understands that a breast ultrasound can add important information to the results of other tests such as a mammogram or Breast MRI to correlate findings.

A breast ultrasound uses sound waves to make a picture of the breast including the area closest to the chest wall, which is hard to study with a mammogram. Breast ultrasound does not use X-rays or other potentially harmful types of radiation, does not replace the need for a mammogram, and is often used to check abnormal results from a mammogram.

A breast ultrasound may be done to find the cause of breast symptoms, such as pain, swelling, and redness or check a lump found during breast self-examination or physical examination. It is used to see whether a breast lump is fluid-filled (a cyst) or if it is a solid lump. A lump that has no fluid or that has fluid with floating particles may need more tests. At Wake Radiology, breast ultrasounds are performed by technologists certified in ultrasonography and interpreted by board-certified radiologists, many of who are dedicated to breast imaging.

If a biopsy is indicated, Wake Radiology will identify the best modality for guiding the biopsy based on the nature and location of the abnormality. Wake Radiology offers three types of image-guided breast biopsy procedures: stereotactic, ultrasound and MRI. We also discuss the initial findings and the specific recommended biopsy procedure with each patient.  Patients may have the procedure performed at our facility or may opt for a surgical referral via the referring physician. In many cases, we are able to offer the patient a same-day procedure, especially for ultrasound-guided biopsy.

While a biopsy appointment typically takes 45-60 minutes, the procedure itself takes only 15-20 minutes. After the procedure, patients can resume normal activity (except for lifting) and exercise within a few days. Wake Radiology schedules the patient to return to our facility two days after the procedure to personally review positive pathology results and appropriate follow-up. We understand the anxiety associated with a breast cancer diagnosis so our approach is distinctly different from other radiology providers in our area who notify patients with a quick phone call.

Pathology follow-up for 100% of recommended biopsies

Wake Radiology follows up on 100% of our recommended biopsies versus the 10% required by the FDA’s Mammography Quality Standards Act (MQSA). We take multiple steps after each of our biopsy recommendations to ensure appropriate follow-up is performed, including a direct conversation with the patient if necessary. We not only do this for every imaging patient we biopsy ourselves, but we also take the extraordinary step of doing this for all our imaging patients biopsied by local surgeons. This unique comprehensive approach ensures the pathologic diagnosis correlates with the breast imaging findings for every patient seen at Wake Radiology. This time-consuming process helps prevent false negatives due to sampling errors and ensures that our team is continually learning and improving.    

For certain patients, Breast MRI is a useful adjunct to screening mammography in the detection of breast cancer and a powerful problem solver for diagnostic dilemmas not fully evaluated by mammography and ultrasound. Breast MRI also provides a clear view of the extent of disease for patients with newly diagnosed breast cancer.  

Advanced method for finding and staging breast cancer

At Wake Radiology, we understand the important role Breast MRI plays in creating a cohesive and effective approach to the diagnosis of breast cancer. While mammography remains the gold standard for breast imaging, it does not have the power of MRI. Breast MRI is the most sophisticated imaging method for detecting and staging breast cancer. Unlike standard mammograms that use radiation to create a flat image, Breast MRI uses powerful magnets and radio waves to create sophisticated 3D images that can reveal far more than mammography. With MRI, the differentiation of abnormal or diseased breast tissue from normal tissue is typically better than with X-ray, CT, ultrasound or other imaging modalities.

Breast MRI vs Mammogram

A mammogram typically is used as the first test for breast abnormalities. If a mammogram detects a problem, further specialized mammography and/or ultrasound may be used. If your doctor is still concerned, a Breast MRI is a diagnostic tool that may be considered. Breast MRI has been proven to potentially have value when other tests are inconclusive.

A Breast MRI should never take the place of your annual X-ray mammogram. Even if you have a normal Breast MRI, you should still continue to have an annual mammogram, one of the most effective tools in breast cancer detection.

You cannot undergo MRI if you having any of the following:

• Pacemaker, unless it’s a Biotronik Pro MRI Eluna or Entovis Pacing Systems
• Residual pacemaker leads
• TENS unit or residual wires
• Defibrillator (AICD)
• Inner ear implant
• Internal pump device
• Brain aneurysm clip
• Metal in your eyes

The following may affect the scheduling of your breast MRI:

• Pre-menopause: Must schedule between days 5-14 of cycle.
• Birth Control Medication: Notify us at scheduling.
• Chemotherapy: Insurance covers MRI before & after completion of therapy only.
• Radiation Therapy: (XRT) Must wait for 6 months after the completion date.
• Lumpectomy: Can be imaged immediately after, before additional therapy.
• Breast Biopsy: Okay for MRI.
• Mammograms: Must have the most recent mammogram and report on site on appointment day.